Sunday, January 17, 2010

The portrayal of smokers as abnormal

In my last article, I reported on a recent study by researchers at UBC (University of British Columbia) dealing with the stigma attached to smoking and, by extension, smokers.

Dr. Kirsten Bell, a medical anthropologist at UBC and lead author of the study, noted the contrast between how smokers are treated, and “the non-judgmental, 'harm-reduction' approach widely applied to people with other addictions.” Dr. Bell and her team suggested: “There is an "urgent" need for governments to revisit their anti-smoking policies, suggesting that the stigma around smoking could lead to patients hiding their tobacco use from doctors, and feeling desperate about ever kicking the habit.“

That contrast was clearly demonstrated by a couple of recent news articles.

Glenrose Hospital is a rehabilitation centre in Edmonton, Alberta and, according to an article in the Edmonton Sun, Glenrose is poised to establish an anti-smoking program for patients at the end of January. Dr. Hubert Kammerer, head of geriatrics at Glenrose, says: “It’s a complex problem. It’s not easy to smoke now, the people who smoke now are hard-core addicts and they need a comprehensive program to help with their addiction.”

Kammerer is right; it's not easy to smoke now, especially in or around hospitals, including psychiatric and palliative care units where patients are prohibited from lighting up and forced to quit, with or without nicotine replacement therapy. No consideration is given to the added stress imposed on smoking patients by forcing them to relinquish their habit under what may be already stressful conditions.

Certainly, no compassion is shown these individuals (Kammerer's “hard-core addicts”); no smoking rooms provided, no protected outdoor space. It's quit or be damned.

According to the Sun article, “The program at Glenrose is targeted toward two groups of patients — one that wants to quit, and another that isn’t ready and needs help coping with withdrawals while in hospital. If patients are willing to quit, they’ll be offered counseling and medicines designed to help minimize cravings.”

The article doesn't specifically say how Glenrose will deal with those smokers who don't want to quit. But, it's safe to assume they will not be offered a designated smoking area should they decline the offer of counseling and nicotine replacement therapy.

Contrast this with the non-judgmental, more tolerant, treatment afforded intravenous drug users who often have access to needle exchange and other programs designed to limit the harm caused by illicit drug use. Compare the current trend in some jurisdictions in providing drug users with “safe injection sites” while depriving smokers of any space in which to engage their habit.

Compare the anti-smoker literature presented to hospital patients who smoke with the literature handed out to intravenous drug users. Another news release reported an initiative launched in New York City, a hot bed of anti-smoker activity. They recently distributed a pamphlet, at taxpayer expense, offering tips on preparing and injecting heroin. Uh-huh.

While Kammerer's “hard-core” tobacco addicts are offered draconian smoking bans, punitive taxation and a host of other “interventions” designed to denigrate and demean smokers, heroin addicts are treated to pamphlets giving them detailed tips on prepping the dope and injecting it into their arm.

The anti-smoker brigade has conducted a deliberate campaign to stigmatize smokers. The consequences have been neither unforeseen nor unintentional.

Dr. Bell and her colleagues cite anecdotal evidence that the stigma attached to smoking may be impairing the doctor/patient relationship. A US survey shows that roughly one in ten patients will try to hide their tobacco use from their doctors. They note a 2005 Canadian Lung Association survey which indicated that: “As many as one in four doctors who responded, admitted to providing lesser care to smokers.”

But, Dr. Bell and researchers at UBC have only seen the tip of the iceberg. They probably didn't have to dig too deep to find their “anecdotal” evidence that the anti-smoker campaign to de-normalize smokers has gone too far. And, when one in four doctors admit they provide lesser care to smokers, then the anti-smoker campaign has indeed gone too far.

Consider the following, some of which have been publicized in the news media.

The head of a cardiology unit in a metropolitan hospital cancels a scheduled angiogram and discharges a patient admitted to hospital with chest pain after learning the patient has continued to smoke after a diagnosis of, and previous treatment for, angina. A 72 year old woman, dying from lung cancer, chooses to die at home rather than the (arguably) more comfortable setting of a hospital or palliative care unit because if she goes into hospital, “They'll take me fags away.”

A 12-year-old boy in the UK who hanged himself with his school tie rather than admit to his parents that he had been caught smoking. Another 12 year old boy in the UK who was admitted to hospital after taking an over-dose of nicotine (nicorette gum) distributed at his school without parental consent.

Recently, there was a horrific example of the affects of anti-smoker efforts to portray smokers as something less than human. An 8 year old boy had his fingers burned with a lighter and matches after he was caught smoking. The babysitter punished the boy while his parents watched. All three were deservedly convicted of child abuse.

But, some measure of guilt belongs to the anti-smoker zealots who have created a climate of fear and loathing of smokers. And the press, the politicians and the public bear some responsibility for their complicity in supporting and promoting the anti-smoker agenda of de-normaliztion.

The anti-smoker zealots will, of course, tell you it's all for our own good; that some collateral damage is to be expected in any war. They plan to save smokers from themselves, even if it means stripping smokers of their humanity. Or, as Dr. Kammerer says: “We . . . need to do everything in our power to help them with their nicotine addiction.” Uh-huh.

Bullshit and bafflegab at it's finest.

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